How is Irritable Bowel Syndrome Different from Inflammatory Bowel Disease?

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are gastrointestinal disorders that share a few of the same symptoms. However, learning the several key differences can help you separate between the two conditions. 

Let’s take a closer look at both conditions, as well as the steps you can take to manage their respective symptoms effectively. 

A Better Understanding of Irritable Bowel Syndrome (IBS) 

IBS is a functional gastrointestinal (GI) disorder. It relates to issues involving the gut-brain interaction. The way your bowel muscles contract can indicate the type of IBS you have. People who have IBS with constipation (IBS-C) excrete stools that are hard and lumpy. IBS with diarrhoea (IBS-D) causes loose and watery stools. IBS with mixed bowel habits, meanwhile, can induce a combination of IBS-C and IBS-D stools on the same day. 

The causes and symptoms of IBS 

The condition occurs in people who are in their late adolescence to early-40s. Interestingly, a woman’s risk of developing IBS is twice as much as a man’s. In addition, a person can also be susceptible if they have a family history of the condition and intolerance towards specific foods or are experiencing emotional disorders (anxiety, depression or other mental health issues). A previous digestive tract infection can also make you prone to IBS. 

Several factors are linked to IBS such as dysmotility, visceral hypersensitivity and brain-gut dysfunction. 

Dysmotility are problems that affect how your GI muscles contract and how food moves through your GI tract. Visceral hypersensitivity describes the delicate nature of nerves in the tract. Brain-gut dysfunction refers to a miscommunication of signals between nerves in the brain and gut. 

Traditional Chinese Medicine (TCM) believes that emotional imbalances, an unbalanced diet and the invasion of external pathogens can trigger IBS. 

“It’s closely associated with spleen, liver, and kidney functions. The spleen is the organ system responsible for digestive roles in the body, whereas the liver and kidney systems can influence these functions”, says Eu Yan Sang TCM physician Ng Qing Xiang. 

As a result, you may encounter symptoms like bloating, excess flatulence, constipation or diarrhoea, abdominal pain or cramps, or even white-coloured mucus in your stools. 

How modern medicine treats IBS  

Making dietary and lifestyle changes can help improve IBS symptoms. Usually, your physician will advise that you increase your fibre intake by consuming more grains, nuts, fruits, and vegetables. 

Also, limit your dairy consumption as you can develop lactose intolerance – common comorbidity in people with IBS. Avoid consuming caffeinated foods and beverages but opt to drink eight 8-ounce glasses of water daily. Do also exercise regularly, avoid smoking, and use relaxation techniques such as meditation to calm yourself physically and mentally. 

If switching up your daily routine fails to achieve the desired effect, you may consider undergoing Cognitive Behavioural Therapy (CBT). Research shows that CBT can help ease bowel-related symptoms and psychological distress while enhancing your life’s quality. A physician can also prescribe medications to relieve constipation, diarrhoea or abdominal pain. 

How Traditional Chinese Medicine treats IBS 

A TCM practitioner recommends treatment options for IBS through syndrome differentiation. Liver stagnation and a spleen deficiency present with symptoms like fatigue, a loss of appetite, pain in the lower ribs, diarrhoea that accompanies abdominal pain, and pain that disappears after you experience anger or stress-related diarrhoea.

Watery stools or dull abdominal pain due to exhaustion or a cold temperature indicates a spleen deficiency with dampness. Stomach heat can be seen in people who struggle with bowel movement, excrete hard stools, have a headache, have bad breath, or have extreme thirst. A pale face and cold limbs are the signs of a spleen and kidney yang deficiency. 

IBS-D can be treated with herbal ingredients like Chinese yam (Shanyao, 山药), lotus seeds (Lianzi, 莲子) and white lentils (Baibiandou, 白扁豆) individually. People with IBS-C can consume cassia seeds (Juemingzi, 决明子), tangerine peel (Chenpi, 陈皮) and pine nuts (Songziren, 松子仁) to facilitate bowel movement.  

You can also apply pressure to acupoints like Zhongwan (CV12), Taichong (LV3), Neiguan (PC6), Yinlingquan (SP9) Tianshu (ST25) and Zusanli (ST36). Doing so helps to manage IBS symptoms by regulating the kidney, liver, spleen and stomach meridians.

A Better Understanding of Inflammatory Bowel Disease (IBD) 

IBD is a term used for two conditions – Crohn’s disease and ulcerative colitis – that give rise to chronic inflammation in the intestines. The former can damage any part of the GI tract but frequently attacks the small intestines. The latter provokes soreness and swelling in the colon and rectum. 

The causes and symptoms of IBD 

Genetics, environmental stimulants, or a defective immune system response can elevate a person’s risk of developing IBD. Hence, one in four people with IBD probably has a family member who might have previously been diagnosed with the condition.

Depression, smoking, and the use of certain medications can weaken your resistance against IBD. It’s worth noting that the body’s immune system can also mistake the foods you consume for foreign substances. Hence, it releases antibodies to fight against this ‘threat’ and exposes your body to the condition.

Consequently, the condition may lead to you experiencing symptoms that are either mild or severe. For instance, you may experience the same symptoms as a person with IBS. You can also be vulnerable to fever, joint pain, skin ulcers and vision loss, albeit to a lesser degree. 

How modern medicine treats IBD 

The proposal of clinical therapies for IBD relies on the type of condition and its symptoms. Medications can ensure remission, while antibiotics treat abscesses and infections. Anti-inflammatory drugs can help minimise intestinal irritation. Biologics interrupt immune system signals that produce inflammation, while corticosteroids and immunomodulators protect the intestines from flare-ups by calming the immune system. 

People with severe Crohn’s disease or ulcerative colitis will eventually need to undergo surgery. It usually happens when medications can no longer relieve symptoms. A surgical procedure for Crohn’s disease – bowel resection – involves removing a diseased bowel segment or connecting two ends of a healthy bowel. Alternatively, a surgeon will remove only the colon or the colon and rectum, connect the small intestines and anus or create an ileal pouch during a procedure. 

How Traditional Chinese Medicine treats IBD 

In TCM, the onset of Crohn’s disease is connected to imbalances in the kidney, liver, spleen and stomach meridians. Practitioners of this medicine system may suggest the use of Shenling Baizhu powder to address liver stagnation and a spleen deficiency. A cold and deficient spleen or stomach can also be treated with Fuzi Lizhong pills, while the Weiling soup is used for cold-dampness in the spleen.  

Changyangan soup warms the kidney and strengthens the spleen in people who are yang-deficient. You can also consume Baitouweng soup to expel damp heat. A stasis-removing decoction that uses safflower (hong hua, 红花), radix Rehmannia (di huang, 地黄) and red peonies (chi shao, 赤芍), among others, work as well.

Conversely, a herbal ingredient called Indigo Naturalis (qing dai, 青黛) and acupuncture exhibits the capability to clinically improve symptoms of ulcerative colitis. In some people, the use of these treatments can also resolve the condition. 

Learning how to separate irritable bowel syndrome from inflammatory bowel disease helps with identifying the necessary course of action. If you are considering herb use, speak to a clinical physician or TCM practitioner. You’ll discover if there are any contraindications and if the herbs are appropriate for your body constitution.